Reducing AR in Primary Care Practice

Reducing AR in Primary Care Practice

Challenges of AR in Primary Care Practice

Accounts receivable refers to the outstanding payments that a primary care practice is owed by patients, insurance companies, or other third-party payers for services rendered. Managing accounts receivable can be challenging for primary care practices due to various factors including, changing payment models, billing complexities, claim denials, managing unpaid patient balances, and high administrative costs. Overall, reducing accounts receivable (AR) in a primary care practice can be complex and challenging, requiring ongoing attention and resources to ensure timely and accurate payment for services rendered. Legion Healthcare Solutions is a leading medical billing company providing complete billing and coding services. While working with various primary care practices, some of the processes contributed more towards reducing accounts receivables. Such processes are discussed in this article.  

Reducing AR in Primary Care Practice

Verify Insurance Benefits

Verifying insurance benefits prior to providing healthcare services is an important step in reducing accounts receivable in primary care. Verifying eligibility and benefits helps to ensure that patients are eligible for the services they are seeking and that the services are covered by their insurance plan. By doing so, providers can avoid costly billing errors and reduce the risk of unpaid claims. Verifying eligibility and benefits includes processes like gathering insurance data, contacting the insurance company, confirming patients’ eligibility, determining coverage, and documenting the information.

Focus on Clean Claim Submission

Clean claim submission in primary care billing refers to the process of submitting accurate and complete medical claims to insurance companies for reimbursement. Your focus on clean claim submission will not only reduce rejected claims but also ensure timely insurance payments. Healthcare practices with efficient revenue cycle management have more than 95% clean claim submission rate i.e., insurance companies have accepted 95% of claims for processing (as such claims are error-free). Try to improve your revenue cycle management operations to achieve more than a 90% clean claim ratio.

Denial Management

Most practices focus on quick claim submission without having major efforts on the claim follow-up process. To reduce your accounts receivable, you should get payment remarks about every single submitted claim. Submitted claims should be categorized as paid, partially paid, and denied. You should form a denial management team who would work on such denied and partially paid claims. Your denial management team should consist of billers, coders, accounts receivable experts, and providers. Your denial management team will identify resolutions for common denial reasons and claim denial trends.

Collect Patient Responsibility

As more patients are accepting high deductible plans nowadays, patient responsibility has increased to a great extent. Following practice management activities will help you in the timely collection of patient responsibility:

  • Offer payment plans: Offer payment plans to patients who are unable to pay the full amount at once. This can help patients to pay their bills in a timely manner and reduce the number of outstanding balances. Offering payment plans can make it easier for patients to manage their bills, reducing the risk of delinquency and increasing the likelihood of timely payments.
  • Send timely and accurate bills: Send bills in a timely and accurate manner. Make sure the bills are itemized, easy to understand, and include all relevant information. If patients have questions or concerns, provide them with the necessary support.
  • Train staff on billing and collections: Train staff on billing and collections to ensure they have the skills and knowledge to effectively manage accounts receivable. This includes training on insurance verification, billing procedures, and collection practices.
  • Follow up on outstanding balances: Follow up on outstanding balances regularly. Send reminders to patients who have outstanding balances, and consider contacting patients who have past-due balances directly to discuss payment options.
  • Collect co-payments and deductibles at the time of service: Collecting co-payments and deductibles upfront can help reduce accounts receivable by ensuring that patients pay their portion of the bill at the time of service.

By implementing these strategies, a primary care practice can reduce its accounts receivable and improve its financial health. If you are low on skilled manpower or can’t dedicate much time towards billing activities, then we can assist you in reducing AR for primary care practice. Our skilled primary care coders and billers have great experience billing for various insurance companies. To know more about our primary care coding and billing services, contact us at 727-475-1834 or email us at